medicina46巻8号

2009年08月発行

今月の主題 ガイドラインを基盤とした心不全の個別診療 トピックス

睡眠時無呼吸症候群と心不全

著者： 百村伸一¹

所属機関： ¹自治医科大学附属さいたま医療センター循環器科

ページ範囲：P.1330 - P.1335

ポイント

●閉塞性睡眠時無呼吸は直接心負荷を増大し，また他の心疾患の危険因子となることによって，心不全の発症に関係する．

●中枢性睡眠時無呼吸は心不全の結果起き，悪循環を形成し心不全を悪化させる．

●閉塞性，中枢性いずれの睡眠時無呼吸も心不全の予後を悪化させる．

●閉塞性睡眠時無呼吸の治療としては，心不全合併の有無にかかわらずCPAPが第一選択となる．

●心不全に合併する中枢性睡眠時無呼吸の治療としてはASV，CPAP，夜間酸素吸入などがある．

●心不全ガイドライン上は中枢性無呼吸を合併するNYHAⅢ度の心不全に夜間酸素吸入の適応がある．

参考文献

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